Frequently Asked Questions
For Greenfield Community College Students
2016-2017 Student Health Insurance Plan
Table of Contents
“How do I…?” .................................................................................................................................................................................... 2
Insurance Plan Benefits ..................................................................................................................................................................... 3
What is covered under the Student Health Insurance Plan?....................................................................................................................................... 3
What changes have been made to the plan for the 2016-2017 Policy Year? .............................................................................................................. 3
Are dental benefits included in the Student Health Insurance Plan? .......................................................................................................................... 3
How much does the plan cost? ................................................................................................................................................................................... 3
Am I required to get a referral from my school’s Health Services before I seek treatment? ...................................................................................... 3
Does this plan cover me when I am off campus, traveling or studying abroad? ......................................................................................................... 3
Will I be covered under the plan after I graduate? ..................................................................................................................................................... 4
Eligibility, Enrollment & Waiving ....................................................................................................................................................... 4
Who is eligible for the plan?........................................................................................................................................................................................ 4
Can I enroll my eligible dependents? .......................................................................................................................................................................... 4
How does Health Care Reform affect the Student Health Insurance Plan? ................................................................................................................ 4
What is considered ‘comparable coverage’? .............................................................................................................................................................. 4
Can I waive the Student Health Insurance Plan with any of the insurance plans offered through my State’s Marketplace?..................................... 4
Is there anything I need to know before waiving coverage? ....................................................................................................................................... 5
Can I enroll in the Student Health Insurance Plan if I lose coverage under the plan I waived with? .......................................................................... 5
Once I’m enrolled in the Student Health Insurance Plan, can I terminate coverage? Can I get a refund?.................................................................. 5
Plan Enhancements ........................................................................................................................................................................... 5
Are there any additional insurance products available? ............................................................................................................................................. 5
Important Contact Information ......................................................................................................................................................... 6
Prepared by Gallagher Student Health & Special Risk
June 27, 2016
Page 1
“How do I…?”
1.
2.
3.
Log in
Learn more about the
MassHealth Premium
Assistance Program
Go to www.gallagherstudent.com/GCC
On the top right corner of the screen, click ‘Student Login’.
Follow the login instructions.
You can call MassHealth Premium Assistance directly at 1-855-273-5903. General
information is available by going to www.gallagherstudent.com/GCC and clicking on
“my Benefits and Plan Information”
If your current coverage is comparable to the Student Health Insurance Plan:
1.
2.
3.
4.
5.
6.
Waive
Obtain an ID card
Go to www.gallagherstudent.com/GCC.
On the left toolbar, click ‘Student Waive’.
Log in (if you haven’t already).
Click the ‘I want to Waive’ button.
Follow the instructions to complete the form.
Print or write down your reference number. Receipt of this number only confirms
submission, not acceptance, of your form.
ID cards are mailed by Blue Cross Blue Shield to the address on file with Gallagher Student
Health & Special Risk. Cards are usually sent 7-10 business days after Gallagher Student Health
& Special Risk has received your enrollment from your school.
If you need a replacement ID card, you can request one by logging into
www.bluecrossma.com/membercentral or calling 1-800-253-5210.
Obtain a tax form
Tax forms are mailed by either the Insurance Carrier or the Claims Administrator. Please refer
to the Important Contact Information Section of this document for further information.
Verification Letters are usually available 5-7 business days after your eligibility is confirmed.
Print a Verification Letter
Change my address
Find a Doctor
Find a Participating
Pharmacy
1.
2.
3.
4.
5.
6.
7.
Go to www.gallagherstudent.com/GCC.
On the left toolbar, click ‘Account Home’.
Log in (if you haven’t already).
On the left toolbar, under ‘My Account’, click on ‘Authorize Account’.
Enter your Student ID number and your date of birth.
Click on ‘Authorize Account’.
You will be redirected to the ‘Account Home’ page, then click on ‘Verification Letter’
under ‘Coverage History’.
1.
2.
3.
4.
5.
Go to www.gallagherstudent.com/GCC.
On the left toolbar, click ‘Customer Service’.
Under the ‘Choose Help Topic’ dropdown, select ‘Address Change’.
Complete the required fields.
Click ‘Submit’.
Go to www.gallagherstudent.com/GCC and click on ‘Find a Doctor’.
Go to www.gallagherstudent.com/GCC and click on ‘Pharmacy Program’.
Prepared by Gallagher Student Health & Special Risk
June 27, 2016
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Insurance Plan Benefits
What is covered under the Student Health Insurance Plan?
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The plan offers comprehensive benefits that include hospital room and board, inpatient and outpatient surgical procedures,
labs and x-rays, chemotherapy and radiation, inpatient and outpatient mental health services, physician office visits,
consultant visits, ambulance, emergency care, and prescription drugs.
Preventive Care Services are available to cover routine physicals and examinations, routine screenings, routine GYN
examinations, and most immunizations with no cost-sharing when services are received by In-Network Providers.
Services provided by a participating In-Network Provider are generally covered at 90%, while services provided by an Outof-Network Provider are generally covered at 80%.
This plan has a $250 per insured per policy year deductible that applies to services received from an In-Network Provider or
from an In-Network Provider combined.
At participating pharmacies, you will pay a $15 copayment for a 30-day supply of a Tier-1 drug, a $30 copayment for a 30day supply of a Tier-2 drug, and a $50 copayment for a 30-day supply of a Tier-3 drug.
Some prescription drugs require a Prior Authorization from Blue Cross or are part of the Step Therapy program. These must
be approved in advance by BCBS before you can fill your prescription. Your medical provider needs to complete a Prior
Authorization form and send it to BCBS. To find out which prescriptions require prior authorization and to download the
form, go to www.bluecrossma.com/pharmacy and click on ‘Pharmacy Management Program’.
Please refer to the plan brochure available at www.gallagherstudent.com/GCC by clicking on ‘My Benefits and Plan
Information’ for complete details about coverage, limitations, and exclusions.
What changes have been made to the plan for the 2016-2017 Policy Year?
There are no plan changes for the 2016-2017 Policy Year.
Are dental benefits included in the Student Health Insurance Plan?
There is a pediatric preventive dental benefit available for students and their enrolled eligible dependents up to the age of
19. Please see the Student Health Insurance Plan brochure for details. For students age 19 and older, please visit the Gallagher
Student Health & Special Risk website (www.gallagherstudent.com) for coverage options available for purchase.
How much does the plan cost?
Annual
Enrollment/Waiver Deadline
Student
(09/01/2016-08/31/2017)
October 31, 2016
$1,629
Spring
(01/01/2017-08/31/2017)
April 15, 2017
$1,088
Am I required to get a referral from my school’s Health Services before I seek treatment?
No, a referral is not required with the Student Health Insurance Plan.
Does this plan cover me when I am off campus, traveling or studying abroad?
Yes, the Student Health Insurance Plan covers you during semester breaks, summer vacation and even if you’re traveling or studying
abroad. You’ll be covered for the period for which you have paid premium.
In addition to being covered for medical treatment and services, you will also be covered for Emergency Medical Evacuation,
Repatriation of Remains, and Travel Assistance Services through ACE Travel Assistance Services, the 24-hour worldwide assistance
service. All services must be arranged for in advance and provided by ACE Travel Assistance Services. Any services not arranged by
ACE Travel Assistance Services will not be considered for payment.
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When studying or traveling abroad, keep your Student Health Insurance ID card with you and take a copy of the brochure
for reference.
When outside of the United States, you will likely be asked to pay for your medical care first and will then need to seek
reimbursement. Covered Expenses will be reimbursed on an Out-of-Network basis.
When you submit claims for reimbursement, you will need to have the itemized bill(s) translated into English and include a
letter informing the claims administrator that you are seeking reimbursement for charges previously paid.
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June 27, 2016
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Please ensure that your name, ID number, address (to receive your reimbursement check), and your school’s name are on
the bill.
Will I be covered under the plan after I graduate?
Yes, you will be covered under the Student Health Insurance Plan until the end of the policy period for which you have purchased
coverage. There is no option to continue coverage after the policy terminates.
Eligibility, Enrollment & Waiving
Who is eligible for the plan?
All full-time students registered for 9 or more credit hours are automatically enrolled in and billed for the Student Health Insurance
Plan unless comparable coverage is received by the deadline.
Students must actively attend classes for at least the first 31 days after the effective date of the period for which coverage is
purchased. Home study, correspondence, and online courses do not fulfill this requirement.
Can I enroll my eligible dependents?
The Student Health Insurance Plan does not provide coverage for dependents.
How does Health Care Reform affect the Student Health Insurance Plan?
If you are under the age of 26, you MAY be eligible to enroll as a dependent under the employer health insurance plan held by your
parent(s). However, before you do so, you should fully compare the employer plan against this Student Health Insurance Plan to
determine which plan’s rates, benefits and coverage are most appropriate for you.
In addition to the items mentioned above, keep in mind that Student Health Insurance Plans are generally less expensive than
individual plans with similar benefits. In fact, your total out-of-pocket cost (including premium and deductibles) may be significantly
LESS with this Student Health Insurance Plan, especially if your parents’ employer plan is considered a ‘high deductible’ plan.
What is considered ‘comparable coverage’?
You need to compare your current health insurance plan to the one sponsored by your school to look at cost-sharing levels
(deductibles and coinsurance) and access to In-Network Providers. The amount of your current plan’s deductible and In-Network
and Out-of-Network coinsurance may result in high out-of-pocket costs. The level of benefits should be compliant with the
Affordable Care Act (ACA) and meet or exceed the benefits provided through the Student Health Insurance Plan. Coverage is
considered comparable if it provides students with access to a range of services in and around the area where they attend school.
Services include, but are not limited to, preventive and primary care, emergency care, surgical care, inpatient and outpatient
hospitalization, lab work, diagnostic x-rays, physical therapy and chiropractic care, prescription drugs, mental health and substance
abuse treatment. Students should be able to seek these services from providers who are considered In-Network or Preferred. If
your current plan is an HMO, it is very likely that coverage is limited, or not available, outside of the HMO’s service area.
Plans that only provide emergency services in the campus area, that are purchased on a short term basis, that are international or
travel insurance plans, or that are out-of-state Medicaid plans are not considered comparable.
Can I waive the Student Health Insurance Plan with any of the insurance plans offered through my State’s Marketplace?
Students are eligible to enroll in an insurance plan offered through the Marketplace in their home State. If you are a Massachusetts
resident, you can waive the Student Health Insurance Plan with a plan purchased through the Massachusetts Health Connector.
Please review these plans carefully. Many of these plans will have a deductible greater than the deductibles on the Student Health
Insurance Plan which will increase your out-of-pocket costs. Also, many of these plans are HMOs with restrictive provider networks,
so look at the provider network to be sure that In-Network Providers are located near your campus.
If you are not a Massachusetts resident, there is good possibility that a plan purchased through your home State’s Marketplace will
not provide adequate coverage. Review this carefully.
Prepared by Gallagher Student Health & Special Risk
June 27, 2016
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Is there anything I need to know before waiving coverage?
If you currently have MassHealth coverage, you may be able to sign up for the Student Health Insurance Plan without paying any
more than you currently do. MassHealth will pay for your Student Health Insurance Plan, if you qualify for the MassHealth Premium
Assistance Program. Just make sure to enter your MassHealth member ID when you fill out your waiver information.
Before waiving coverage you should review your current policy, considering the following:
 Will your current plan cover medical care beyond emergency services (i.e. doctor’s office visits, diagnostic testing, x-rays,
prescription drugs, mental health, etc.) on- and off-campus?
 Does your plan have doctors and hospitals near campus?
 Check the cost -- is the annual cost of this Student Health Insurance Plan less expensive than the cost of being added as a
dependent to your parents’ plan? Be sure to compare deductibles and total out-of-pocket costs, not just the annual
premium.
 Are there administrative pre-requirements, pre-certification, or Primary Care Physician referrals required under your
current plan that may delay receipt of care?
Please Note:
 Students who do not complete a waiver form by the published deadline will be automatically enrolled in and billed for the
Student Health Insurance Plan.
Can I enroll in the Student Health Insurance Plan if I lose coverage under the plan I waived with?
Yes, students who waive the Student Health Insurance Plan, and then lose coverage under that plan, may submit a Petition to Add
form. The form can be found by visiting www.gallagherstudent.com/GCC and clicking the ‘Petition to Add’ link on the left side of the
page. Make sure you read the form carefully as it contains very specific information on the Petition to Add process.
Once I’m enrolled in the Student Health Insurance Plan, can I terminate coverage? Can I get a refund?
There are specific instances when a student who is enrolled for annual coverage can request a termination. Other than those
instances which are identified below, students enrolled in the Student Health Insurance Plan will remain enrolled in the plan for the
period of coverage charged to their student account.
Students enrolled in annual coverage may only request a termination of coverage and a pro-rated refund of premium in the
following situations:
1. When a student enters the armed forces.
2. When a student is enrolled in annual coverage and has one of the following occur:
a. Student disenrolls from school for the spring semester.
b. Student becomes eligible and enrolls in a subsidized Health Insurance Plan through the Massachusetts Health
Connector during the same policy year and coverage is effective on or before the start of the spring health
insurance coverage period (not academic spring semester).
c. Student becomes eligible and enrolls in MassHealth during the same policy year (excluding MassHealth Limited,
the Health Safety Net or the Children’s Medical Security Plan) and coverage is effective on or before the start of
the spring health insurance coverage period (not the academic spring semester).
For the second option above, the request for termination of coverage must be received by Gallagher Student Health & Special Risk
no later than the last day of fall coverage.
Plan Enhancements
Are there any additional insurance products available?
Please visit www.gallagherstudent.com/GCC and click on the ‘Other Insurance Products’ link for complete details about additional
insurance products that are available as well as enrollment information.
This document is intended to provide a summary of the available benefits. Please refer to the brochure for a complete
description of the benefits, exclusions, and limitations of the plan.
Prepared by Gallagher Student Health & Special Risk
June 27, 2016
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Important Contact Information
Information Needed
Who to Contact
Questions about enrollment,
coverage, benefits or ID
cards
Gallagher Student
Health & Special Risk
Questions about benefits,
claims, and claims payments
BCBS of Massachusetts
Questions about preferred
providers
Blue Care Elect PPO
Questions about
participating pharmacies
Express Scripts
Questions about tax forms
Worldwide assistance
services (medical evacuation
and repatriation)
BCBS of Massachusetts
Contact Information
Gallagher Student Health & Special Risk
500 Victory Road
Quincy, MA 02171
Phone: 1-877-307-8194
Website: www.gallagherstudent.com/GCC
Blue Cross Blue Shield of Massachusetts
Phone: 1-800-241-0803
Website:
www.bluecrossma.com/wps/portal/members/myaccount
Phone: 1-800-821-1388
Website: www.gallagherstudent.com/GCC, click ‘Find a
Doctor’
Phone: 1-800-892-5119
Website: www.gallagherstudent.com/GCC, click
‘Pharmacy Program’
Blue Cross Blue Shield of Massachusetts
Phone: 1-800-241-0803
Website:
www.bluecrossma.com/wps/portal/members/myaccount
Toll-free within the United States:
1-855-327-1414
ACE Travel Assistance Services Collect from outside of the United States:
1-630-694-9764
Email: medassist-usa@axa-assistance.us
Questions about assistance
programs
Prepared by Gallagher Student Health & Special Risk
June 27, 2016
Blue Care Line
Phone: 1-888-247-2583
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